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Multicenter review of robotic versus laparoscopic ventral hernia repair: is there a role for robotics?

Peter Walker, MD1, Audriene May, MD2, Monica Rosales Santillan, BS1, Steven Kim, BS2, Shinil Shah, DO1, Erik Wilson1, MIke Liang, MD1, Shawn Tsuda, MD2. 1University of Texas Health Science Center at Houston, 2University of Nevada School of Medicine at Las Vegas

Introduction: The utilization of robotic platforms for general surgery procedures such as hernia repair is growing rapidly in the United States. At this point, a limited amount of data is available evaluating operative outcomes in comparison to standard laparoscopic repair. We completed a retrospective review comparing robotic and laparoscopic ventral hernia repair to provide safety and outcomes data as a template for future prospective trial design.

Methods: A retrospective review of 215 patients (142 robotic repairs and 73 laparoscopic repairs) was completed at two large academic centers. Primary outcomes included hernia recurrence, incidence of primary fascial closure, and surgical site occurrences. Secondary outcome measures included length of stay and operative time.

Results: Patient demographics showed that patients undergoing laparoscopic repair had a higher body mass index (BMI) (35.7 versus 31.7, p < 0.01); however, there was no difference observed in mean hernia diameter. Hernia recurrence was the same in each group (8.1% versus 8.1%). Robotic repair was associated with a higher incidence of primary fascial closure (71.1% versus 56.3%, p = 0.05) as well a lower incidence of surgical site infection (0% versus 7.6%, p < 0.01) and seroma formation (9.6% versus 22.6%, p = 0.02). Review of operative times showed laparoscopic repair to be significantly faster (98.7 minutes versus 116.9 minutes, p = 0.03).

Conslusions: Our retrospective data shows that laparoscopic repair was favored in larger patients with shorter operative times. Robotic repair was associated with an increased incidence of primary fascial closure; however the recurrence rates were equivalent. With limited sample size, the data showed a decrease in surgical site occurrences with robotic repair. As robotic assisted laparoscopic ventral hernia repair increases in popularity, additional prospective trials need to be designed in order to investigate the efficacy, safety, and cost effectiveness of this evolving technique.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 80552

Program Number: S066

Presentation Session: Robotics

Presentation Type: Podium

88

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